Member Question: Cleat Position

How do I know if my cleats need to be adjusted? And how do you know in which direction to adjust them? I have been having medial knee pain and edema but my LBS says the cleat placement is fine.

Member Question from Aquagirl

How do I know if my cleats need to be adjusted? And how do you know in which direction to adjust them? I have been having medial knee pain and edema but my LBS says the cleat placement is fine. Will Speedplays perhaps be the answer? I currently ride Keos with the red (more float) cleat.

Proper cleat positioning and pedal alignment can be one of the most complicated yet very important aspects of bike fitting. It’s not uncommon for me to spend up to half my bike fitting time addressing cleat, foot, and alignment issues. If you haven’t had a cleat fitting performed by a reputable fitter then it’s certainly something I’d recommend. Poor cleat positioning and/or pedal alignment can often times be the cause of the knee pain you’re describing. While it’s difficult to diagnose your exact problem via email, it sounds like something that the following guidelines will help address. In our experience your problem could be caused by poor cleat positioning, but it’s also likely that saddle position or the need for forefoot varus canting could be the needed solution.

The ball of your foot is the area that will transfer all of your power to the pedal. We position the cleat under the most stable portion of the ball of your foot which typically falls under the ball of the 2nd toe – or just behind the 1st metatarsal head (the 1st metatarsal head is typically the widest point on the inside of your foot). This cleat location provides a central leverage point that maximizes both power transfer and stability during the pedal stroke.

Both Speedplay and Look Keo pedals have enough float options to provide the right solution for every rider. I wouldn’t recommend one pedal system over another in this case since they both are well equipped to address the problem if used properly. It’s more important to make sure that you’re using the correct amount of float with each system and that the cleats themselves are positioning properly. In the case of the Speedplays, we recommend the more updated “Zero” pedals which allow you to adjust the amount and direction of float the cleat provides. This allows a good bike fitter the ability to give you the right amount of float under each foot and minimize the risk for excessive float. In some cases excessive float can lead to knee pain due to the increased demand on the knee to stabilize a foot that’s floating excessively during the pedal stroke.

There’s a possibility that your red Look Keo cleats are allowing your foot to float to a degree that’s causing the medial knee pain. If you find your heel rotates toward the bike during the downstroke, then reducing this float with the gray Look Keo cleats is a possible solution to reduce strain on that part of your knee. If my other recommendations don’t help, then this is certainly something to try.

In our experience, medial knee pain is most often caused by pronation of the foot or the knee traveling toward the bike during the downstroke. The human foot was designed for walking and running, not rigid shoe sports like cycling. In the case of pronation, the foot will roll inward in some combination of arch collapse and forefoot twisting to provide cushioning. In a rigid shoe sport like cycling, this inward rolling of the foot causes the knee to travel toward the bike in a repetitive manner every pedal cycle. This repetitive motion puts extra strain on the medial side of your knee which can eventually lead to pain, injury, and/or edema like you describe. If this scenario is what’s causing your pain, then I’d recommend using forefoot varus cant wedges underneath the ball of your foot or a custom footbed. Both of these solutions will reduce the forefoot twisting and pronation during your pedal cycle and reduce the strain on the medial side of your knee. We’ve had a lot of success using in-the-shoe cant wedges from Bike Fit Systems, but there are other solutions on the market as well. A custom footbed or orthotic will provide the best ankle and arch stability in addition to forefoot support.

Outside of cleat positioning and pedal alignment, we’ve also had success reducing medial side knee pain by raising the saddle height. Increasing the saddle height will reduce the strain on both the front and medial sides of the knee. This is another option to look into if you can’t resolve your problem with the solutions I described above. If you adjust the saddle height, I recommend only adjusting it 2-3mm at a time and see how your knee responds.

Remember, once your knee is inflamed you’ll need to give it the necessary time to calm down. Depending on the severity of the pain, backing off on the cycling and seeking the proper help from a doctor or physical therapist may be best. You may find the correct solution on the bike, but if that part of your knee isn’t calmed down you may still experience pain.

Author

FitWerx

Fit Werx offers the most scientific and complete bicycle fitting services in New England, the Northeast and beyond. Regardless of where you are from (Massachusetts, Connecticut, New York, New Hampshire, Maine, Rhode Island, Florida, Pennsylvania, Texas, Vermont, Australia, Macau...) a Fit Werx' bike fit is guaranteed to be worth the trip.

Author

FitWerx

Fit Werx offers the most scientific and complete bicycle fitting services in New England, the Northeast and beyond. Regardless of where you are from (Massachusetts, Connecticut, New York, New Hampshire, Maine, Rhode Island, Florida, Pennsylvania, Texas, Vermont, Australia, Macau...) a Fit Werx' bike fit is guaranteed to be worth the trip.